Psoriasis: what you need to know
What is psoriasis?
Psoriasis is a common chronic skin condition, characterised by red, scaly, thickened patches. The patches occur most commonly on the knees, elbows and scalp, although the skin can be affected anywhere on the body. The nails may be involved, and a small number of people also get pain and swelling of the joints (psoriatic arthritis).
Although people of any age can be affected, the most common age for psoriasis to start is late teens to early adulthood.
What causes it?
The exact cause is not known. However, it is known that the immune system in the skin is overactive in people with psoriasis. This causes the skin cells to be turned over at a faster rate than normal, leading to thickening and scaling.
The condition tends to run in families, so inherited factors have a part to play. Also, certain factors, such as infection or stress, may trigger episodes of psoriasis.
What treatments are available?
Psoriasis is a chronic (ongoing) condition that tends to fluctuate with time. While there is no cure, in most cases the disease can be well controlled.
Various treatments are available, depending on the severity of the disease and the areas of skin involved. There is no single treatment that suits everyone. It may be necessary to rotate through a series of different treatments, or use a combination of treatments to get the best control.
Some people with very mild disease may need only topical treatments (treatments applied directly to the skin). These include emollients (moisturisers), special shampoos, and bath oils. Topical treatments that doctors may prescribe include tar, cortisone, dithranol and calcipotriol (vitamin D-based) ointments and creams.
For people whose disease isn’t controlled by topical therapies or who have quite widespread disease, another treatment option is ultraviolet light therapy (phototherapy). This requires specialist supervision, so it is mainly available through hospitals or some dermatologists’ practices.
Other treatment options for those people with more severe disease include oral medications such as methotrexate, acitrecin (a vitamin A-based medicine) and cyclosporin. While generally very effective, these medications can have potentially serious side-effects, so close monitoring by the doctor is required.
More recently, a number of new biological agents have become available for the treatment of psoriasis. While effective, these medications (which are all given by injection) are expensive, so their use in Australia is currently limited to those with severe disease.
Last Reviewed: 06 December 2005
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